Wikipedia classifies transgender surgery as medical necessity

 Separate from surgery performed for medical need, such as transgender surgery

https://en.m.wikipedia.org/wiki/Plastic_surgery

http://web.archive.org/web/20211015235434/https://en.wikipedia.org/wiki/Plastic_surgery

In contrast, unnecessary health care lacks such justification

https://en.m.wikipedia.org/wiki/Medical_necessity

http://web.archive.org/web/20210411011236/https://en.m.wikipedia.org/wiki/Medical_necessity